Mothering with Motherwort

Today I’m taking some time to be thankful for Motherwort, Leonurus cardiaca. This lovely lady grows in my garden and comes with me in a tiny amber bottle just about everywhere I go. You ready to hear why I love this plant so much?

A note of disclaimer: information here is for educational purposes only and not for diagnosing, prescribing, or treating any ailment. You are your own best judge of your health and well-being, and the person who makes all final choices about your health (even when working with a doctor) is you! Okay, onto the herbs!

Parts Used: Aerial parts

Main Herbal Actions: Nervine, emmenagogue, antispasmodic, hepatic, cardiotonic, hypotensive, bitter

Indications for Use: The names of this plant give some idea of its range of uses. It’s common name “Motherwort” points to its uses for menstrual and uterine actions, while its species name “cardiaca” suggests that it has some action on the cardiovascular system. The full Latin name “Leonurus cardiaca”, or ‘lion hearted’, is one that many herbalists take to be the nature of this plant as a Nervine; a plant which protects the spiritual heart as well as the physical one. 

As an emmenagogue, this herb can be used to stimulate menstruation which has been delayed or suppressed. It is particularly indicated when anxiety or tension lay at the root of this problem. There is also some indication for using this herb in formula to address painful menstruation or premenstrual symptoms. This stimulating action is why Motherwort is not recommended in early pregnancy, but is often used during labor. When contractions are “false” or prodromal, this herb has been known to ease the pain and quiet the contractions, drawing on its antispasmodic action. During early or active labor, Motherwort is frequently used when labor becomes eratic, uncoordinated, or stalls; its action as an emmenagogue stimulates the smooth muscle contractions and helps labor progress with a normal pattern. It is also found in many ‘herbal induction’ formulas for this reason. Motherwort contains alkaloids that may be responsible for its uterotonic properties (leonurine) as well as for stimulating the release of oxytocin in the human body (stacydrine). Combined with its actions as a Nervine to relieve anxiety and help individuals feel centered, this herb is often a great choice when indicated during labor or late in pregnancy. Adding to its uses for the female body, Motherwort is also a relaxing tonic for menopausal changes. 

As a cardiotonic, Motherwort is excellent for strengthening the heart without straining it. It is specifically indicated for tachycardia or hypertension, particularly when anxiety is involved. It is thought to be protective to the myocardial cells, but evidence for this is not yet clear.

What Studies Show: One study from 1996 showed that an alcoholic extract of Motherwort demonstrated cardio activity in vitro(outside of a living organism). It directly inhibited calcium chloride on myocardial cells, provided the calcium chloride was administered after. It was also shown to stimulate both a- and B- andrenoreceptors. The dosage and methods used in this study are unclear. Another study in 1992 put forth some preliminary research which suggests that alkaloids contained in Motherwort are effective in lowering blood pressure and making changes in the central nervous system. 

Safety During Pregnancy and Breastfeeding: Individuals receiving other cardiac treatments should be cautious adding Motherwort into the mix as it is unknown how it will interact with medications. This herb is not recommended during the first trimester, and should only be used with guidance from a professional during other parts of pregnancy. There are no known contraindications for use during breastfeeding. 

 

The moral of this story is that I love Motherwort. I turn to this herb when I’m having trouble saying “no”, when I’m feeling emotionally vulnerable, or when my stress is causing chest symptoms (racing heart, heart palpitations, chest tightness, chest heaviness, etc). I keep Motherwort tinctures in my car, my purse, on my desk, and in my birth bag. What a versatile friend to have!

Be Calm with Lemonbalm

Welcome back to my blog, and thanks for reading! In an effort to create more content, I’ve decided to highlight some herbs that are super useful during the childbearing year. A note of disclaimer: information here is for educational purposes only and not for diagnosing, prescribing, or treating any ailment. You are your own best judge of your health and wellbeing, and the person who makes all final choices about your health (even when working with a doctor) is you! Okay, onto the herbs!

Lemon Balm, also known as Melissa officinalis, is a perennial herbaceous plant. It has a history of medicinal use dating back more than 2000 years. The leaves can be used as a tea, supplement, or extract.

Herbal Actions: Carminative, relaxing nervine, sedative, antispasmodic, anti-depressant, diaphoretic, antimicrobial, hepatic, anti-viral

Indications for Use: Lemon balm is an excellent digestive herb. It relieves spasms in the digestive tract and is useful in cases of dyspepsia. It is indicated in cases of bloating or excessive gas, and may be useful in cases of infant colic if ingested by the breastfeeding mother. The volatile oil in this herb acts on the interface between the digestive tract and the nervous system and is best indicated when there is also anxiety or depression. The oils are gentle sedative and relieve stress and tension reactions.

Lemon balm is considered a trophorestorative for the nervous system. This herb is indicated for use with neuralgia, anxiety-induces palpitations, insomnia, and migraines. It is a cardiac tonic which helps the circulatory system function normally and causes mild vasodilation of the peripheral vessels. This blood vessel action helps to lower blood pressure. Anxiety and high blood pressure are the most likely indications for use during pregnancy.

Water-based extracts of lemon balm make best use of its antiviral properties. It can be used internally for colds and flus or externally for viral lesions such as herpes.

It has some indication in cases of urinary incontinence and may be helpful when added to a formula created to address this.

What Studies Show: There have been limited studies on the use of lemon balm. Short term studies show that this herb is capable of benefitting mood and performance. It was shown to improve working memory and alertness.

Safety Considerations During Pregnancy: Lemon balm is considered likely safe for short term use. There is no research regarding the safety of this herb during pregnancy. Lemon balm may interfere with the action of thyroid hormones and should be avoided if there are any concerns about thyroid function. It is also considered a mild emmenagogue and should not be consumed in the first trimester of pregnancy. As always, when trying new herbs during pregnancy, a low dose should be used first and careful attention paid to the body’s response to this supplement.

In Practice: I have seen Lemonbalm used frequently in my practice as a doula and student midwife. I’ve witnessed it having a very consistent affect in helping to cease the upward creep of blood pressure that some people can experience late in their pregnancies. Usually I recommend it in combination with something like Dandelion root or Motherwort. Typically my clients use Lemonbalm as a tincture or a capsule, however I tend to recommend the form of this herb that best fits the lifestyle of my client. Frankly, not many people drink tea daily.

Recently I had the pleasure of seeing a regimen of St Johnswort, Lemonbalm, vitamin D, and Omega 3 supplements have a wonderful effect on a client suffering with prenatal anxiety and depression. This client’s wish was to avoid pharmaceuticals, so we began this regimen at 33 weeks gestation and within a month saw a complete turn around. We did need to adjust the dose a few times, but once it was correct client reported that she no longer felt regular anxiety or panic.

Curious about using Lemonbalm in your life? Why not try growing it first, its a lovely plant that’s available from a lot of different places (even walmart!) and grows well in a pot so long as it has full sun. Happy Gardening!

Ruby Memorial and Other Updates!

It’s been a busy winter! Today, I’ve finally had to chance to sit down and do some updating and reflecting on my work from the past few months.

I had the privilege to spend a few days working at Ruby Memorial Hospital this March with the amazing Certified Nurse Midwives who practice there, and even some of the attending doctors and residents. I was able to observe both the beautiful and awful parts of hospital birth. The births I witnessed ranged from normal and natural with wonderful staff, to very managed and medicated with staff who did not outwardly show compassion toward their patient.

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When talking about hospital birth, many doulas and midwives tend to focus on the latter type described above. One of my take-aways from my time was that the kind of horror stories that get passed around, while sometimes true, are not the complete picture.  Part of what I now understand is how things can line up to create the circumstances for one of these awful experiences, and that no one on the staff is intentionally working toward that. It seem to me that there can be a perfect storm of exhausted, inexperienced, or transient staff that lands on birthing folks without much support. Seeing this only further cements my belief that doulas should be available to anyone who needs one, and that their services should be covered by insurance. While I sometimes feel conflicted about hospital-based doula programs, I would still love to see them more.

That kind of textbook terrble hospital birth was only one of six that I witnessed. I also saw some medicated births which were incredibly well supported. Mothers with epidurals and inductions who had compassionate and knowledgeable nurses that took time and care with them. Labors that ended in beautiful and uncomplicated births, and patients who were very happy with their choices and care. I saw natural, unmediated, and intermittently monitored labors; births where the staff were very hands off and respectful of the process and the time that it takes. I am so happy that this hospital has some incredible humans working in their childbirth center.

One of the most fascinating things I observed were the interactions between nurses, doctors, residents, students, and midwives all sharing the same space and working toward the mutual goal of safe deliveries. I have a deeper understanding now of the whys and hows of hospital birth that were perplexing to me before. I see just how much work it is to simultaneously manage the labor, birth, and postpartum care for so many different individuals. It was a whirlwind week, with long hours, laughs, and so much coffee! I’d like to say another great big Thank You to all the staff that helped me learn more about hospital birth 🙂

After spending some time in Morgantown, I’ve been getting back to work here updating my paperwork and birth log. I am now up to 2 catches and 26 total births! Hooray! I’m now only a few births away from crossing into a new phase of my training. I am about to start working as a primary midwife under supervision. I am really excited to be moving along so quickly and I can’t wait to start catching more babies!! Keep checking on my Facebook and website for more updates, and thanks for reading.

 

Giraffe Watch 2019

I don’t usually jump on the viral bandwagon, but here I am about to write an absurd blog post about April the Giraffe and what we can learn from the livestream of her birth. [Disclaimer: this is going to mostly be a comical post that is 90% opinion and maybe 10% facts about mammalian birth. Don’t take it all seriously, but do take it a little seriously…]

Once again, several hundred thousand of us found ourselves checking in on a livestream of a pregnant giraffe doing absolutely nothing, hoping that she might suddenly pop out a calf while we were watching (I’m going to leave aside the ethics of putting a webcam on a pregnant animal who can’t consent to it, but don’t shy away from thinking about how that might make you feel near your due date). Luckily for me, I have friends who are much more obsessed with this YouTube channel and whom I could trust to quickly alert me when hooves appeared. I certainly would not get sucked into checking the livestream at 2am and watching for labor signs again(lets imagine this is the equivalent of texting your friend every single day after her due date to ask if she’s had a baby yet). I tried to take my own advice concerning due dates by having patience and trusting that someone would let me know if something important was happening. Let someone else text April the giraffe at 4am to ask if she’s feeling any contractions.

This morning while loosely monitoring a group chat, it happened. I saw the word “HOOVES” and I knew one of the craziest displays of mammalian birth was about to happen live on Youtube. So I put the livestream on our tablet in the living room and subjected my family to the agony of waiting for a baby giraffe to emerge. Giraffes are queens of slow birth. To begin with, they gestate for somewhere between 400 and 460 days ending with a 6ft tall, 150lb infant. Even though the pelvis of a giraffe is quite ample for the task, it can still take hours from when the first hooves emerge until the birth of the entire calf. Earlier today, an absurd amount of us humans watched a giraffe freely roam about her labor room with actual hooves protruding from her vagina for hours. I couldn’t help but think, if we’re fine with a giraffe walking about with a significant portion of her baby sticking out of her, when will we finally all be on the same page regarding the freedom of movement for humans during their labor and delivery? We watched as April walked, paused, licked her infant’s hooves, and continued walking again to help move her baby out. My three year old said things like “wow, her neck is so long that she can lick her own butt” as we assembled a new Harry Potter lego set, occasionally glancing up to examine April’s progress. Though she is somewhat domesticated, I have no doubt that April gave no fucks about our preconceived notions of how her labor was supposed to go. Like most animals she did what came naturally to her and got her baby out just fine by herself. I only lament that she was confined to such a small area and did not have the company of other female giraffes. It’s purely conjecture here but since giraffe groups are mostly segregated by sex and familial ties, I imagine that they naturally give birth supported by a herd of other female giraffes.

The moment of birth for a baby giraffe is something fairly shocking if you’ve never seen it before. Giraffes give birth standing up, and when you consider that they are the world’s tallest land mammal…Well you can certainly imagine that a baby giraffe’s entrance into the world is something of a fall; its a big, wet, ungraceful flop earthside. Yet, we did not see her care-providers jumping in to catch this baby and suction it immediately. In fact her care givers were completely hands off during this whole experience, simply on hand to help out in an emergency. To add to that, there was no panic when it took baby more than an hour to nurse, as it takes many human newborns when given appropriate time to acclimate and self-attach to the nipple. Alright, by now I’m sure your sick of me touting the lessons we should learn from April the giraffe, but I’ve got one more. Her caretakers announced that in light of the birth of a healthy baby, they have left her area to give her privacy and would be performing a newborn examination tomorrow. I’m over here self aware of the satirical nature of my blog post today, and also very serious when I say that in the case of a normal labor and delivery no matter what species #handsoff the #slowbirth and when it comes to examinations of the well newborn #itcanwait. Lets try to give our human parents and babies time to bond with their newborn in the immediate postpartum, and afford them the same courtesy that we are giving to a giraffe in New York today.

If you didn’t see the fantastic birth of April’s new baby, you can check it out at Animal Adventure Park’s Facebook page and YouTube channel.

The Low Down on Due Dates

So, what is your due date anyway? It’s an estimate of when your baby will be born based on the first day of your last menstrual cycle calculated by adding 280 days to that date. This number would bring you approximately to 40 weeks of gestation. It assumes a 28 day menstrual cycle and a normal time of ovulation.

Some providers might calculate a more accurate date based on other details that you provide, particularly if you have an irregular cycle or know the day that you most likely conceived. Providers may further adjust the estimated due date with information gathered from early ultrasounds. A word of caution to parents about this: early ultrasound measurements (in the first trimester) are the most accurate for this. The margin of error for these measurements is often cited as approximately 2 weeks, however as gestation progresses the margin of error increases. One study states that for measurements taken from ultrasounds at 17-36 weeks, errors in estimation of gestational age could be as much as ten weeks. To put that in perspective, a trimester of pregnancy is between 12 and 14 weeks.

The 40 week estimate of birth falls roughly halfway within a range of normal. Babies are considered “term” at 37 weeks of gestation, however they are not considered “post dates” aka ‘overdue’ until 42 weeks gestation. Yup, you read that right. You aren’t out of the range of normal gestation until after 42 weeks. Even then, we must allow for the fact that some healthy individuals may still fall outside this range and have a normal birth and a well baby. This considered, some pregnancies carried past 42 weeks are not healthy, and most providers using evidence based practices will increase surveillance around 41 or 42 weeks depending on other factors in the pregnancy.

So, when will you give birth? There isn’t any way to know when your body will naturally go into the process of labor. Some recent study suggests that there are more factors than healthcare professionals first assumed that contribute to when labor begins. These factors include (but are not limited to) variable time of implantation, early hormone levels, age, weight, genetic factors, and events in the first two weeks of pregnancy. It has also been stated that factors traditionally thought to influence length of gestation such as BMI, alcohol intake, parity (how many prior pregnancies), and sex of the baby do not show any association to the time of birth. The conclusion of the particular study is:

“Human gestational length varies considerably even when measured exactly (from ovulation). An individual woman’s deliveries tend to occur at similar gestational ages. Events in the first 2 weeks after conception are predictive of subsequent pregnancy length, and may suggest pathways underlying the timing of delivery.” View it here

If this leaves you feeling confused, here’s my take-away. The length of a healthy, normal pregnancy is extremely variable. Your due date may be a useful piece of information for you, but it may lead to some stressful interactions with friends and family toward the end of your pregnancy. My advice is to pick a less specific estimation of when your baby will come, maybe cite your most likely birth month when asked about your due date. You can even go less specific than that and tell folks the season that your baby is due. For example, my son was due August 18th, but I often told people that he was due in August or late summer.

My hope is that this can help folks avoid the stress of a barrage of phone calls, texts, and Facebook messages that I see starting to pile up for my clients after 40 weeks. Pregnancy and birth can be stressful, so lets do our best to avoid unnecessary anxiety. If someone you love is pregnant, trust that they will announce their birth when they are ready and resist the temptation to call/text/message unless you’re offering support as the pregnancy continues. If you are pregnant, consider going offline after 40 weeks. Take some time to yourself and your close family to enjoy the last portion of your pregnancy and the ability of your body to grow an entirely new human.